Not Mid Morning Matters

JD in the Morning, off air…

Tag: Doctors

Experts; aren’t we all?

What makes Doctors think they are special, “so very special” that they don’t have to work 7 days a week like many of us? Actually, in reality, Doctors do already work 7 days a week on rota but they currently get more money for weekends than what’s being offered in their new, soon to be imposed contract. How you side in this Junior Doctor’s dispute, be it the emotive BMA “patient safety” or the Government “manifesto commitment to a 7 day NHS” against the constant “crisis” backdrop the NHS is always in, the whole thing is all about money.

Back to the initial question. What makes Doctors think they are special? Is it the commitment to be a doctor that starts in their early teens when they select their GCSE’s? Is it the vision, commitment and passion to select and get the right A Levels and grades to match? It could be the 4/5 years at Medical School followed by a decade or more of training, exams, more training and more exams? Maybe it is the constant changing of jobs and hospitals to gain vital experience, which could also mean travelling 100’s of miles a day, including at weekends? Perhaps it’s the failed relationships and missed family moments as being a doctor is all-consuming? Hard to know really what makes a Doctor special but in a world of Google and Social Media, where we can diagnose ourselves without having to do any of the above, what’s the point of all that effort and commitment? Doctors aren’t special. We don’t need experts.

During the now widely discredited Referendum Campaign (discredited on both sides in a report by the Electoral Reform Society published this last week) one of the most revealing moments was when Leave campaigner Michael Gove (remember him) said “I think people in this country have had enough of experts”. Experts had been telling us what might happen if we chose to Leave or Remain in the EU. It is fair to say that following the result to leave on 24th June all of the doom predicted by those experts has not happened, so far. In fact, after the initial shock, the UK economy has returned to pretty much where it was when the (then) Prime Minister David Cameron (remember him) called The In/Out Referendum in February this year. It’s been a very long 7 months.

Is Michael Gove right in his assertion that we don’t need experts? Is our existential age a time of instant information and connectivity to anything, everything and everyone making us all instant experts? We can now have hundreds of “friends”, we crave “likes” and most of us have more “followers” than Jesus could manage when he was “alive”. Does this means we don’t need real experts, doctors, elected politicians, public servants, journalists, newspapers, radio, TV because we can all get what we want when we want it, all at a click or swipe or scroll? The internet has democratized information and for those who wisely choose to go beyond one single source of information or a single “trusted” news site we can be better informed. You can check and cross reference anything.

Yet there is a problem with all this. If we don’t like what we see, read or hear we can trash it, troll it, attack it and get our “friends” and “followers” to pile in too. We don’t need experts. Your opinion is not mine. Your politics is not mine. Your race is not mine. Attack. We live in the moment were we can easily be extreme and many relish this. We are entitled to do so. We are entitled. Nobody is worth more money than me. Nobody. Social Media is allows us to be everything including judge, jury and expert.

Starting with newspapers many centuries ago, for almost the last hundred years radio followed by TV was all we had. This so-called traditional media is now changing fast to adapt to the social media world and rightly too. As this old media tries to marry with the new maybe the new needs to respect the old a little bit more than it currently does. Our rush toward Social Media is not taking account of the long path it took to get to this point. It took hundreds of years from the first printing press to create the first mass-produced published book. Facebook is just 12 and half years old. Would you just trust a 12-year-old with your life, business and future? We need to respect what was and how it came to be more than we currently doing or we risk losing the bath water, baby and the bath.

This is the case with junior Doctors too. We need to respect what happened in the past. This past and path gave us the Consultant Medics and Surgeons we rely on today and will have to rely on even more with the coming strikes. Both sides in the Junior Doctors dispute would do well to remember this and would do better to talk less and listen more. Doctors know better than most the power of listening. It saves lives. Taking a “history” is vital to diagnose and treat anyone. We need to respect our past, our experiences and do a little less existential scrolling, clicking, swiping and living. Doctors are special and we do need experts.

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It’s gonna cost you being ill

In the last few weeks, doing my day job, I have talked with those who are living with dementia and cancer. They have told me about how these dreadful diseases have touched their lives. I have also heard how dementia and cancer has changed their lives and how their lives have never been the same since they found out they have these two potentially devastating illnesses in their lives.

A generation ago you couldn’t even say the word cancer on hospital ward, let alone at home. Nobody talked about it and if you actually, eventually got ‘the diagnosis’ that was pretty much it. Get your affairs in order if you can, the clock is ticking and you can’t wind it up any more. A generation on and cancer is not the killer it once was. Some cancers are still not treatable and are fatal but most are livable, most are treatable. Today you can have a life and do something while you live with cancer. Linda Bellingham proved this beautifully, with great style and great humour too.

Dementia today is where cancer was a generation ago. We are still in denial over it, there are very few treatments for it and there is currently no cure for it. Cancer and our success in tackling it means that dementia has now been exposed for the illness it is. It’s not inevitable it will get you as you get older but, like cancer, you have a one in three chance of ‘the diagnosis’ and those odds are not good enough for you and me.

The principle problem with dementia and all its various types is getting the actual diagnosis. We know there are no treatments or cure and because of this we don’t want to face having to be assessed to see if we have it. As it stands the medical profession is currently not equipped or skilled enough to recognise the signs of dementia, treat it or cure it, much in the same way they were with cancer 30 years ago.

So giving GP’s £55 to diagnose dementia is ridiculous and it’s abhorrent. GP’s shouldn’t be paid a fee to do something that they should already be doing. If it’s a training need for GPs then train them but paying per diagnosis of dementia is just wrong. What next? £10 per cold and a £5 for ‘it’s a virus’?

The reality is that doctors already earn good money and they have to commit to a profession that takes their all. That is the deal. I used to be married to one and I am in awe of all she has done and still has to do every single day. All doctors constantly learn and train. It’s what they do. Adding dementia to their continued professional development should not be a problem. Dementia is fast becoming the health issue of our time and every doctor would benefit from this specific focus in their training.

The other issue we all have to face is that healthcare costs far more than we are all paying at the moment. Like or not every drug used costs millions to develop, prescribe and that has to be paid for. Every doctor, nurse, care assistant has to be trained, developed and rewarded and that has to be paid for. Every bit of the NHS has to be paid for. And the NHS needs to be managed and that has to be paid for too. 113 billion pounds is not enough to run the NHS you and I want. We are just going to have to more for it to use it.

The NHS is not free. It was never set up as ‘free’ and now, with health challenges like dementia, unknowns like Ebola, further advances in cancer care and its treatment we, you and me, are going to have to pay for it. Maybe we will not be paying for ourselves but for others, our loved ones to be treated and cared for. One thing is certain we are not paying enough today.

Here is THE question. Would you pay what you could to save your partner, your child, your parent? I would. I would give all I could. It’s about time we all faced up to that reality.

Another reality is that the NHS is not a political football to be kicked between the political parties claiming they can make it better. They have both made a mess of it, through under investment, PFI, miss management and perpetual reorganisation starting back with Enoch Powell in 1962 and every government of every colour since. They one thing politicians have not be fundamentally honest with us about the NHS is its cost. A NHS set up in 1947 is not equipped for 500,000 people living over the age of 90 and all the medical advances to today. Our healthcare success is the NHS financial failure.

If you and me want the NHS, to save the NHS, use the NHS you and me are going to have to pay for the NHS, if we can. Dementia proves it and the political parties need to stop prancing about saying they can do better and be honest about our healthcare.

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